Ohio lawmakers hear details on Medicaid expansion

ANN SANNERAssociated Press Published: February 14, 2013 6:39 PM

COLUMBUS, Ohio (AP) -- Ohio lawmakers had their first chance Thursday to hear more details on Gov. John Kasich's plan to expand Medicaid to cover more low-income residents under the federal health care law.

Included in the Republican governor's proposal is an "opt-out" trigger, in case the federal government rolls back its financial commitments to cover the cost of the newly eligible. A Kasich administration official emphasized that piece of the plan to lawmakers amid wide-ranging testimony before the House finance committee.

Greg Moody, director of the governor's Office of Health Transformation, described the provision as a "circuit breaker" that would shut down the program should there be future changes out of Washington. He said it would be up to who's running the state then to restart the program.

Under the law, the federal government will pay the entire cost of the Medicaid expansion for the first three years, gradually phasing down to 90 percent. That's still well above the state's current level of 64 percent. Even at those generous rates, some GOP governors and state legislatures say they fear being stuck with long-term costs.

Moody told lawmakers that protecting taxpayers was a primary concern for the Kasich administration as it weighed whether to expand Medicaid.

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Republicans dominate the House committee and control both chambers in the Ohio Legislature. Kasich needs their support for the proposal to go through. Many Republicans are averse to President Barack Obama's signature health care law and resistant to expanding government programs.

The state anticipates roughly 366,000 Ohioans will be eligible for coverage beginning in 2014 by expanding Medicaid, the health program for the poor that already provides care for one of every five residents in the state. Ohio would see $2.4 billion from the federal government to cover those newly eligible for Medicaid over the next two years beginning in July, and $13 billion over the next seven years, according to the Kasich administration.

Kasich has framed his decision as recapturing Ohio residents' tax dollars from the federal government.

"We're not naive about how complicated this issue is politically," Moody said. "If it were just about the politics, you know it would be easy to make probably the opposite decision."

The difficult choice wasn't lost on state Rep. Gerald Stebelton, a Lancaster Republican.

"It's like you've been chased into a closed room by a lion only to find a python inside," Stebelton said.

Moody replied: "Thank you for the image, which does characterize how this feels."